除了肺癌外，柴油排放与其他癌症和非恶性健康结果的相关健康效应尚不明确。我们将"柴油排放对矿工的影响研究"的死亡随访延长了18年（截止至2015年12月31日），将观察到的死亡人数增加到4,887人，以评估死亡率与柴油排放暴露之间的关联。对所有工作岗位、年份和设施，使用从每个矿山收集的测量结果和历史测量结果，创建了对可呼吸元素碳（REC）的历史暴露的定量估计，它是柴油排放的替代指标。在整个队列和工人位置（地表、地下）估计了标准化死亡比率（SMR）和危险比（HR）。我们观察到肺、气管和支气管癌死亡率过高（n= 409; SMR = 1.24; 95% CI：1.13，1.37）。在曾在地下工作的工人中，即柴油暴露最严重的地方，肺、气管和支气管癌的过高死亡率也是明显的（n= 266; SMR = 1.26; 95% CI：1.11，1.42）。曾在地下工作的工人中，多种非恶性疾病与过高死亡率相关，包括缺血性心脏病（SMR = 1.08; 95% CI：1.00，1.16）、脑血管疾病（SMR = 1.22; 95% CI：1.04，1.43）和呼吸系统非恶性疾病（SMR = 1.13; 95% CI：1.01，1.26）。持续15年滞后的累积REC暴露水平低于1,280μg/m3年与肺癌风险增加相关（HR = 1.93; 95% CI：1.24，3.03），但在最高暴露水平时风险下降（HR = 1.29; 95% CI: 0.74, 2.26）。我们还观察到，在20年滞后的累积REC的增加与非何杰金淋巴瘤（NHL）风险的增加之间存在显著趋势（HRTertile3 vs. Tertile1 = 3.12; 95% CI：1.00，9.79; p趋势=0.031）。 原研究中观察到的肺癌死亡率风险增加仍然存在。柴油暴露与NHL的死亡风险以及与呼吸系统和心血管系统疾病的过高死亡相关的关联需要进一步研究，并为柴油暴露可能广泛影响公共卫生的证据提供了支持。

With the exception of lung cancer, the health effects associated with diesel exhaust for other cancers and nonmalignant health outcomes are not well understood.We extended the mortality follow-up of the Diesel Exhaust in Miners Study, a cohort study of 12,315 workers, by 18 y (ending 31 December 2015), more than doubling the number of observed deaths to n=4,887, to evaluate associations between mortality and diesel exhaust exposure.Quantitative estimates of historical exposure to respirable elemental carbon (REC), a surrogate for diesel exhaust, were created for all jobs, by year and facility, using measurements collected from each mine, as well as historical measurements. Standardized mortality ratios (SMRs) and hazard ratios (HRs) were estimated for the entire cohort and by worker location (surface, underground).We observed an excess of death for cancers of the lung, trachea, and bronchus (n=409; SMR=1.24; 95% CI: 1.13, 1.37). Among workers who ever worked underground, where the majority of diesel exposure occurred, excess deaths were evident for lung, trachea, and bronchus cancers (n=266; SMR=1.26; 95% CI: 1.11, 1.42). Several nonmalignant diseases were associated with excess mortality among workers ever-employed underground, including ischemic heart disease (SMR=1.08; 95% CI: 1.00, 1.16), cerebrovascular disease (SMR=1.22; 95% CI: 1.04, 1.43), and nonmalignant diseases of the respiratory system (SMR=1.13; 95% CI: 1.01, 1.26). Continuous 15-y lagged cumulative REC exposure <1,280 μg/m3-y was associated with increased lung cancer risk (HR=1.93; 95% CI: 1.24, 3.03), but the risk declined at the highest exposures (HR=1.29; 95% CI: 0.74, 2.26). We also observed a significant trend in non-Hodgkin lymphoma (NHL) risk with increasing 20-y lagged cumulative REC (HRTertile3 vs. Tertile1=3.12; 95% CI: 1.00, 9.79; p-trend=0.031).Increased risks of lung cancer mortality observed in the original study were sustained. Observed associations between diesel exposure and risk of death from NHL and the excesses in deaths for diseases of the respiratory and cardiovascular system, including ischemic heart disease and cerebrovascular disease, warrant further study and provide evidence of the potential widespread public health impact of diesel exposure. https://doi.org/10.1289/EHP12840.